Evaluating permanent impairment in compensation claims requires a thorough clinical assessment that includes taking into account the injured party’s medical history, and all other relevant medical information.
There are several factors that need to be determined to evaluate whether the injured party is permanently impaired or not. A positive outcome needs to ensure the following:
- That the claimant’s condition has reached maximum medical improvement (MMI). This is to say that it’s unlikely that the condition or injury will improve or get any better in the future either with or without medical treatment.
- That the injury or condition that the injured party is claiming compensation for has caused the permanent impairment.
- It must be confirmed that the impairment is permanent and will not materially change in the future.
- It also must be determined what degree of permanent impairment has resulted from the injury/accident that compensation is being claimed for.
- While looking at the medical history of the claimant, it must be confirmed that the permanent impairment was not caused by a previous injury. If it was made worse by a pre-existing condition then an apportionment must be performed.
What the Medical Assessor Needs to Show
The Assessor must be a registered medical practitioner and be recognised as a medical specialist.
As the assessor evaluates the case for permanent impairment, he or she must arrive at a diagnosis of permanent impairment that was caused by the injury that the claimant is seeking compensation for. In the diagnosis, it’s also necessary to make any deductions for previous injuries or conditions that may have made the current permanent impairment worse.
The final decision will state the following:
- The level or degree of permanent impairment that was caused by the injury that is being claimed for.
- Any deductions that need to be taken into consideration from previous injuries or pre-existing conditions. These deductions need to be clearly identified and calculated.
- Any injury or condition that had not previously been identified and the connection that this may have to the current impairment that is being claimed for.
In determining the degree of permanent impairment, the assessor has access to various case histories and guidelines in the Worker’s Compensation rules.
It’s important to note that if it’s determined that the condition has not reached the stage of maximum medical improvement or that the treatment to date has been inadequate, then the assessment needs to be deferred until adequate treatment and rehabilitation have been given.
What About Multiple Impairments?
If multiple impairments have been caused by the claimable injury or accident, these will be assessed together. These will then help to determine the degree of permanent impairment that the injured party can claim.
The medical assessor has access to various guidelines that will help to calculate the percentage of whole person impairment. Basically, this relates to how much of the claimant’s normal bodily functions required for daily living are permanently impaired by the injury or accident.
To sum up, permanent impairment is evaluated through a comprehensive medical assessment that takes into account the injured party’s medical history and past injuries. The medical assessor will determine the level of permanent impairment to put forward in the case for compensation.